Prof. Stephen Davidson: Opposition to Obamacare Is Maddening

In “POV,” BU Today‘s new opinion page that provides timely commentaries from students, faculty, and staff on a variety of issues, Professor of Health Care Management Stephen Davidson writes that many opponents of the Affordable Care Act (ACA), which was officially implemented earlier this month, are uniformed. Davidson finds that the opposition hasn’t taken the time to learn the facts, or simply doesn’t care to learn them. He continues, explaining why he believes reform is “critically important to the future of the American health care system.”

One reason, of course, is that millions of Americans have not had insurance, and therefore, have lacked access to beneficial medical services. In addition, US health care spending, which already is the highest in the world by far, is still growing, thus making it harder both for employers to continue to provide good coverage to employees and their families and for individuals to buy insurance even when their employers offer it. Finally, quality of care is too unreliable. Quality measures vary widely from state to state. Even doctors, when they or their families are patients, have trouble getting the care they know they need.

These are serious problems, and the continuing failure to deal with them makes them worse. In 2010, the president and his congressional allies were able to pass the ACA, which, while not perfect, addresses all of these problems in ways that are reasonable. If fully implemented, the health care system will improve, and we will all benefit.

What are some key provisions? Practically all Americans must obtain health insurance (the “individual mandate”). Those who have trouble paying for it may be eligible for subsidies to help. Moreover, insurers must provide coverage for all who seek it, even those with prior medical conditions, and except for age, may not charge individuals more because of personal characteristics, even factors that increase the risk of needing care. Thousands of young adults up to the age of 26 are still covered on their parents’ insurance policies while they continue as students or look for a job with coverage. According to estimates, in 2012, almost 13 million people received rebates totaling more than $1 billion because private insurers spent more than the maximum permitted by the law (85 percent for large-group insurers; 80 percent for those in the individual and small-group markets) on overhead, executive compensation, and profit instead of on medical services and efforts to improve quality of care. Health insurance exchanges should make it relatively easy for individuals to compare competing insurance policies and to choose the one that is best for them. And many provisions encourage reform of the way care is delivered and paid for to increase quality and save money.